Conflicting Opinions From 5 Surgeons. How to Get Perky C in My Case? (photo)

I am confused by conflicting opinions from Doctors over my sagging boobs. I'm 5' 3", 118#'s, mother of 2, age 40. I've always had asymetrical breasts, now they are deflated after nursing two children and undergoing multiple biopsy's after discovering micro-calcifications in my breasts two years ago. Two areas of conflicting opinions: Area 1 Breast Lift, Area 2: Size I want Mentor Moderate Plus Silicone implants under the muscle. How can I end up with a Perky set of "C's" without a lift?

Doctor Answers (15)

Our vote: implants alone

+2

You will see from this site that cosmetic surgery is art and aesthetics, and multiple opinions are the rule. In our practice you look like a typical breast augmentation candidate and we would not hesitate to put you into submuscular gel implants without a lift. Size is an individual choice (with limits) so make sure you show your surgeon just how you wish to look.


Chicago Plastic Surgeon
4.0 out of 5 stars 30 reviews

Perky breasts

+2

I would recommend a peri-areolar mastopexy or lift with moderate plus gel implants. It should look quite perky and good with an appropriate sized implant.

Rick Rosen, MD
Norwalk Plastic Surgeon
5.0 out of 5 stars 10 reviews

Implants alone may help

+1
95% of my patients who have been properly selected for breast augmentation without a lift to address sagging are satisfied with the amount of lift they achieve with implants. The right implants and technique can help you address mild to moderate sagging with breast augmentation alone, by taking into account the size you'd like to be and the amount of lift you require during the pre-surgery planning process.

These three things are considered to help give you the extra lift you require to make your breasts “perkier” without mastopexy:

1) During your breast augmentation, the breast implants will be placed directly under the breast tissue and above the chest wall muscle (in the sub-mammary position).

2) The best breast implants to use for a perkier result contain silicone gel that is more cohesive, such as the Allergan Inspira Truform 2 (formerly known as Soft-Touch gel). These implants are slightly firmer to maintain their shape better, but still retain their natural feel.

3) The shape of your breast implants should have more, rather than less, projection. Breast implants with a smaller base width will make your breasts project more forward from your chest wall and body, creating a more prominent contour. “Profile” is a synonym for projection, therefore look for high profile implants.

Generally speaking, larger breast implants can also help give a better lift, sometimes raising the position of the nipple by one or two centimetres.

Please see an experienced board certified plastic surgeon to find out whether you are a suitable candidate. Best of luck.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 70 reviews

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Breast Enhancement Surgery

+1
I would offer a dual plane breast augmentation with implants in the 330-350 range for a natural yet perky result

Ryan Neinstein, MD, FRCSC
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Breast Asymmetry - Conflicting opinions

+1

Thank you for posting your Qs with your photos.  You have deflated breasts with moderate asymmetry.  If your goal is for a perky C with good symmetry then I would recommend an implant with peri-areolar uplift. Implant alone would require different size implants and improve the breast fullness and shape but not achieve perfect symmetry.  You need to take into account that you are trading some degree of asymmetry (which is common) with surgical scars which are permanent.  You should discuss with your Plastic Surgeon your aims and all of the options.  Good luck

Christopher J. Inglefield, MBBS, FRCS
London Plastic Surgeon
3.0 out of 5 stars 2 reviews

Conflicting Opinions

+1

The fact that you have received so many different opinions means that there might not be a best answer for you.   I would select a surgeon that you are comfortable with in regards to bedside manner, reputation, and surgical skills. 

In my hands, I will give you my best result with a breast augmentation with peri-areolar lift.   You have much more loose skin on your left breast that will need a more aggressive lift to achieve balance.

 

I wish you a safe and healthy procedure!!

 

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 41 reviews

Breast asymmetry

+1

Your posted photos show significant asymmetry with the right breast smaller than the left, the left nipple lower than the right and a different distribution of breast tissue under the nipples on the right vs. the left. You can call it a lift or adjunctive breast surgery procedures or whatever else you want to call it but you will need to do something to the breasts besides stick implants in them. If you only augment them (even if you use a larger implant on the right) you will still magnify the asymmetry and most likely will not be happy with the result. It is much better to first do some procedures to the breast to make them more similar (adjust nipple position and breast tissue distribution under the nipples) and then insert breast implants (at the same operation). You will be much happier if you do it that way.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Different opinions tell you that there is no absolutely right answer

+1

Looking at your photos, it reminds me how sometimes in plastic surgery, there is no absolutely one right answer for a particular problem.  All of the opinions that you have gotten are not wrong and there is not one answer that is particularly perfect for your breasts.  

You have asymmetry.  Most women have one breast that is a little different than the other.  Implants will get you to the size that you want.  A lift will give you the most symmetry that you can achieve.  If you just get breast implants, you will have the exactly the same amount of asymmetry that you have that will carry over to your results.  It makes sense since, the implants are the same size and shape and the only differences that you will see in between your breasts are the differences that you started out with.  

The left breast is a bit droopier than the other but both breasts have some amount of droop. A lift will correct this but it will not make them look absolutely the same.  One breast will always be a little different than the other.  

So, I would recommend breast augmentation with silicone implants under the muscle with a periareolar lift (donut lift) with more skin removal (lift) on the left than the right for maximum chance at symmetry.

 

Richard H. Lee, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 15 reviews

Conflicting opinions on augment/pexy

+1
I think it is important not to tell patients what they want to hear but to be truthful about what surgery can and cannot accomplish. An augment alone will not correct your breast asymmetry and difference in nipple heights. To do this, you need a mastopexy; there are many variations on the procedure but a periareolar mastopexy would be appropriate. The implant you are proposing would be fine. Everyone has her own interpretation of a "perky C" so I think it is important to get past the label and have a meeting of the minds with your surgeon as to the shape and size desired.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

More opinions

+1

The more people you ask the more opinions you will get. Surgery can be as much an art as a science. Different surgeons can get to the same place with different techniques. There are no guarantees. Do not choose your surgeon by how they will get you where you want to be, or by trying to tell them how to do the operation.

 

Choose the surgeon you have confidence in and you feel understands your goals. If you cannot get what you desire with the scars you want then you either have to consider the scar pattern recommended but the surgeon or accept that you will not get the results you desire and surgery may not be for you. In the end remember that the results will change over time.

David M. Kahn, MD
Palo Alto Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.